Browsing by Author "Pereira, S."
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- Fasting Glucose Metabolism in PregnancyPublication . Ferreira, C.; Silva, V.; Matos, Ana; Moura, P.; Pereira, S.The HAPO study found a continuous association between hyperglycemia at 24-32 weeks of gestation, below the diagnostic levels of gestational diabetes mellitus (GDM), and adverse pregnancy outcomes, suggesting the need to reconsider the diagnostic criteria for GDM. Recently, a consensus for diagnosis of diabetes in pregnancy was published, based on the results of the HAPO study. Diagnosing for diabetes is considered already in the first trimester with fasting plasma glucose (FPG), but oral glucose tolerance test is recommended to be performed only at 24-28 weeks of gestation. Identifying all pregnant women at risk for GDM in the first trimester would allow an individualization of obstetric care and establishment of a dietetic and exercise plan since earlier stages of pregnancy with potential benefits for both mother and fetus. The glycemic metabolism varies throughout pregnancy, as insulin resistance increases during pregnancy. However the cut-off values for blood glucose tests in screening and diagnosing GDM are independent of gestational age. The objectives of this study are to verify if the pregnant women with and without GDM diagnosed in the second/third trimester are already different from each other in the first trimester regarding FPG levels and to study the evolution of the FPG throughout pregnancy.
- Maternal BMI, weight gain and IOM weight gain recommendations in the prediction of obstetric outcomesPublication . Henriques, Carla; Malva, Madalena; Matos, Ana; Anderson, J.; Ferreira, C.; Pereira, S.It is well known that body mass index (BMI) and weigh gain in pregnancy (WG) have a great influence in obstetric adverse outcomes. We wish to evaluate the effect of BMI on the birth weigh and risk of cesarean delivery. Also with respect to these outcomes, we wish to investigate the effect of the weigh gain in each class of BMI, trying to evaluate the adequacy of the IOM (Institute of Medicine) weigh gain recommendations for the population under study. Linear and logistic regression methods were applied and some comparisons were made through parametric and non-parametric tests. The study group consisted of 764 live birth singleton pregnancies, delivered at a Portuguese Hospital. We observed a significant influence of BMI on birth weight and risk of cesarean delivery, independently of maternal weight gain. The influence of WG on birth weight and cesarean delivery was not statistically significant for the obese women. This may be explained by the fact that this subgroup of patients were already at increased risk. Moreover, for the underweight women the weight gain has revealed a great impact on the birth weight. Regarding the IOM recommendations on weight gain we found a significant predictive ability towards prediction of cesarean delivery and birth weight, excusing the use of BMI and/or maternal weight gain information. This suggests that IOM weight gain recommendations seem to be appropriate to describe the risk of cesarean delivery and birth weight in the Portuguese population studied.